Individual
ELIZABETH JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
221 WILLOW ST, YARMOUTH PORT, MA 02675-1770
(508) 404-0827
Mailing address
221 WILLOW ST, YARMOUTH PORT, MA 02675-1770
(508) 404-0827
(508) 514-7936
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/30/2016
Last updated
04/06/2024
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